Article

Purpose : To determine the comparative effectiveness of consistent cooling using
an icing device (DonJoy Iceman, DJO Canada, Mississauga, ON) versus intermittent
cooling using an ice bag (usual care) for the first 48 hours after total knee
arthroplasty (TKA). Method :
A sample of 78 patients (intervention group, n=37;
control group, n=34) undergoing primary TKA were randomized to intervention
(device) or control (ice) groups. The primary outcome was pain intensity,
measured by numerical pain rating scale (NPRS). Secondary outcomes were passive
range of motion (PROM), nausea or vomiting, opioid use, blood loss, lower limb
function, hospital length of stay, and patient-reported compliance and
satisfaction. Results : No significant differences in the primary outcome (pain
intensity measured via NPRS) were observed between control and intervention
groups. Patients in the intervention group were significantly more satisfied (8.4
vs. 6.0, p=0.002); used the device more consistently, day and night (85.7% vs.
29.6% and 87.6% vs. 30.8%, respectively, p<0.001); and were more likely to
recommend this method of cooling (96.8% vs. 68.0%, p=0.004). Conclusion : The
study found no additional benefit of consistent cryotherapy using the icing
device over intermittent ice bags on postoperative pain, PROM, nausea or
vomiting, opioid use, blood loss, lower limb function, or length of stay, despite
significant differences in patient-reported compliance and satisfaction.

Langue : ANGLAIS